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Your questions answered: What parents need to know about the new COVID-19 vaccine for kids

Health Canada will announce the approval of the Pfizer-BioNTech vaccine for children ages five to 11 on Friday, CBC News confirmed. Dr. Jacqueline Wong, an infectious diseases specialist, and Tracy Akitt, a Child Life Specialist, answered your questions about the vaccine.

Experts from McMaster Children's Hospital spoke with the CBC about what parents need to know about the vaccine

What parents need to know about the COVID-19 vaccine for kids. Experts take your questions

2 months ago
Duration 29:32
CBC Hamilton's Conrad Collaco s[poke with Dr. Jacqueline Wong, an infectious diseases specialist, and Tracy Akitt, a Child Life Specialist, both from McMaster Children's Hospital, about the new COVID-19 vaccine for kids between the ages of 5 and 11. 29:32

Health Canada will announce the approval of the Pfizer-BioNTech vaccine for children ages five to 11 on Friday, CBC News confirmed. Dr. Jacqueline Wong, an infectious diseases specialist, and Tracy Akitt, a Child Life Specialist, answered your questions about the vaccine.

Wong and Akitt spoke with the CBC's Conrad Collaco about what parents need to know before kids receive the vaccine. Read an edited and abridged transcript below or hit play above and watch the entire interview. 

If it's true that kids between five and 11 are not at great risk of negative outcomes from COVID-19, why should they get the vaccine? 

Dr. Jacqueline Wong: This is a common question that I'm seeing in the office as well. And I'm very thankful and grateful that kids have not been experiencing high rates of severe outcomes like we've been seeing in adults. Part of the reason for vaccination, of course, is preventing these severe outcomes. But part of it is also preventing infection as well, and especially for kids that are at school. For parents that are working it can be an inconvenience to have a COVID-19 infection, it can be an inconvenience to have to take that time off work and to feel really crummy when you're unwell with COVID-19. So for some people, this is an important reason to go ahead with the vaccination but scenarios can vary from family to family and household to household.

By getting the vaccination and decreasing the chance that you have an infection, you're also decreasing the chance that you would bring the infection into the house and expose other people at home who are either not eligible to get the vaccine for age reasons or medical condition reasons, or people in the household who are at higher risk of complications. 

For example, let's say, a multigenerational household or if there are other family members there who are immuno-compromised or have certain medical conditions that might put them at higher risk for severe outcomes. So, thinking about the reason for getting the vaccine, of course, starts with the benefit for the child but also, who else lives with the child.

Tracy Akitt: I think, you know, we've talked about how scary this disease can be for the general public, and children have heard adults talking about the need to be vaccinated. And so, quite honestly, I don't think it will come as a surprise to children that they too expect to be vaccinated if that's something they're medically able to do. So, you know, sometimes I think we underestimate just how resilient children are. And quite honestly, they too want to do the right thing. And so it's really just setting everyone up for success. 

Be positive when talking to your kids about getting the needle, expert says

What should parents say to their kids about taking this vaccine?

Tracy Akitt: Sure. This information that I'm going to share is information we should always use, not just when we're talking about the COVID vaccine. Health care experiences are life skills that are essential for everyone, and it's important right from the beginning that we are honest and open with our family members, regardless of age, about what's to take place. And so, you know, parents do know their children best. There are some youth that are very anxious and certainly with the pandemic and the extra stress and toll that it has had on families. We're certainly seeing higher incidents of youth that are anxious, as we are with adults as well. So, I think we need to be particularly sensitive to how much we tell children and how we tell them and really meeting them where they are emotionally. And so I always tell parents a couple of things. First of all, it's important for us as adults to reflect on how we are coping with needles because our children are always watching and listening.

If they hear us in the background complaining about having to have a poke or talking about needles or 'that's going to be so hard' or I don't know how my child's going to do that, you know, the child will be listening and they'll take on some of those emotions. So, I think the first thing I always remind parents is to be positive about it and not to assume that how they may feel about a needle receiving a needle is how their child will feel. 

And if in fact receiving a vaccine is a really challenging thing for them, maybe they need to look at having a different support person go with their child to receive that vaccine. And certainly in our own household, that's always been me, not my husband's favourite thing. We talk about that and that's our coping plan. So the first thing is setting yourself and your family up for success in how you approach the vaccine. This is a two dose vaccine at this point in time. And so that's the other reason why it's particularly important that we're honest about what we're doing because we need the children to come back a second time. 

It's a life skill. All these youth that are probably, I would say, under seven, the five to seven-year-olds, this may be their first vaccine or first poke since they were babies. So, it's a new experience for them. It's an opportunity to demonstrate their resilience and their ability to practice coping strategies. So we want to ensure that we set them up for success and as part of that, there are tips and tricks that people can use to make that more successful, so positive attitude in approaching the vaccine and going to receive it having a coping plan.

Expect vaccine to be ready by the new year, infectious diseases specialist says

Chris, on Twitter asks: When will the vaccine be available? He's hoping for a smooth rollout. He has an 11-year-old who's getting anxious because the 11-year-old wants to do what his 12-year-old buddies are doing right now. 

I'm sure people are fed up of hearing us say it'll be soon but I really think it is imminent because all the data and the information is now with Health Canada, and they're going through their due process to look at what's available and provide their final recommendation about whether this vaccine has a good balance of efficacy and safety for this age group. And then once they give their approval, which everyone is expecting, they will, it's just a matter of when. Then we wait for the National Advisory Group, and that kind of governs the recommendations for how these vaccinations are rolled out. And then each province is going to make their decision about how they're going to roll out and when.

I think it's very reasonable to be expecting children to have their first dose into their arms before the new year. 

We have another question coming in from social media people wondering how the vaccine for kids between the ages of five and 11 is different than the vaccine that people above the age of 12 have received. What can you tell us about that, Dr. Wong? 

Dr. Wong: That's a good question, because it wasn't too long ago where even Dr. Tam was saying it's not like they took the adult formulation and portioned it out into smaller bits and are going to be using those portions for kids. So on the one hand, the amount of active ingredient in this case, the mini vaccine part, that's at a lower dose, so it's 10 micrograms rather than the adult dose. Now, the company is also saying that the makeup of some of the adjuvant, so the items or the components in the vaccine that help boost your body's response to it is that the combination of those things might be a little bit different now because it's not marketed in Canada, it's not totally publicly available in terms of what some of these differences might be. But I'm sure people can find it online because they've gone through this process in the states to find out exactly some of those minor differences. 

Katie wants to know what the best option is for parents of children who are not yet 12 years old but have been directed by their doctor to get a full dose vaccine due to their physical size? 

Dr. Wong: The recommendation would be that we would follow the age brackets because these are the age groups that the vaccines have been studied at their particular doses. So, I think, you know, especially when you're recommending a vaccine, when you're recommending a therapy in terms of balancing the risks and the benefits and having that conversation with the family, I think most people would stick to the way that it was given in the original studies. And so it wasn't based on physical size or weight. It was based on their and their calendar age, though I can understand the rationale for that recommendation. But when you look at the original studies, there's reason for why they stuck with the 10 microgram dose and not the other doses that they chose as well. 

I would encourage providers and prescribers if they're not sure of what dose to go back to what was studied in the original trials to talk to a colleague who might have some expertise in the area of vaccination and vaccinology. 

When not to get the vaccine

Are there any children who based on pre-existing health conditions should not be getting the vaccine right now or in the next couple of months? 

Dr. Wong: It'll be interesting to see how the different regulatory bodies come out with their recommendations about whether this vaccine is going to be ready for everyone in that age group at the same time or whether they're going do it in a staged rollout. Certainly, if you had an allergic reaction to one of the components in there, that's a reason not to get it. In terms of pre-existing medical conditions, one that's been talked about a lot would be a previous history of myocarditis or a previous reaction to this vaccine. So if there is a condition that a family is worried about, they should definitely have that one on one conversation with the provider that knows them best, be it their specialist or their primary care provider. 

If that conversation still yield some questions, then of course, referring to a special immunization clinic. We have one at McMaster Children's for further conversation because we just want to make sure that these resources are available to families to have these conversations, because at the end of the day, we want to make sure that families are comfortable with their decisions. 

Tracy, are you seeing a lot of vaccine hesitancy in your work and your conversations with families and children? 

Akitt: To date the 12 and up age group, most of those youth were not that hesitant. They saw and appreciated what the vaccine offered as far as protection for themselves and their friends and that opportunity to do more activities and get back to a normal social life. And so for the most part, people were very on board with it and keen to have it completed. The people who have been apprehensive that I have come across are the ones who have anxiety related to a needle experience. Those are the people that are still trying to show up and trying to do their best to be immunized.

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